Reconstitution of Solutions Chapter 12 Reconstitution of Solutions © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

Parts of Solutions © Cengage Learning 2013 © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

Reconstitution Process of mixing and diluting solutions Terms Solute Substance to be dissolved or diluted; can be solid or liquid © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

Reconstitution (Continued) Solvent Substance (liquid) that dissolves another substance to prepare a solution Solution Resulting mixture of a solute plus a solvent © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

Caution Before reconstituting injectable drugs, read and follow the label or package insert directions carefully Check the drug Check drug and diluent dates © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

Reconstituting Injectable Medications Determine both the type and amount of diluent to be used Determine volume in mL of diluent to be used for the route as ordered Reconstitute the drug and not the resulting supply dosage on the vial © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

Parenteral Solution from a Solid Solute Solvent or diluent 4.8 mL sterile water 5 mL reconstituted solution Zithromax 100 mg per mL Solid solute Zithromax 500 mg © Cengage Learning 2013

Reconstitution Label for Zithromax 1/10/xx, 0800, reconstituted as 100 mg per mL Expires 1/17/xx, 0800. Keep refrigerated. G.D.P. © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

Parenteral Solution Reconstitution Procedure Order: Kefzol 225 mg IM every 6 hours © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

Parenteral Solution Reconstitution Procedure (Continued) Withdraw 1 mL Kefzol solution for dosage of 225 mg Inject 2 mL air into sterile water diluent vial Make Kefzol 500 mg in 2.2 mL reconstituted solution for Kefzol 225 mg/mL Add 2 mL sterile water to Kefzol 500 mg powder Withdraw 2 mL sterile water © Cengage Learning 2013

Rule When reconstituting multiple-dose injectable medications Verify the length of drug potency

Remember Label reconstituted multiple-dose medication with Date and time of preparation Supply dosage prepared Length of potency Storage directions Your initials

Math Tip When multiple directions for diluting are given, the smaller the amount of diluent added, the greater or stronger the resulting solution concentration will be © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

Reconstitution Drug Order Supply: 500 mg vial of powdered Solu-Medrol for IM or IV injection Reconstitute with 8 mL bacteriostatic water for Injection with benzyl alcohol Methylprednisolone sodium succinate equivalent to 500 mg methylprednisolone (62.5 mg per mL) © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

Reconstitution Dosage Calculation What do we know? First, to fill the order, how much and what type of diluent must you add? Directions state to add 8 mL of bacteriostatic water for injection with benzyl alcohol © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

Reconstitution Dosage Calculation (Continued) Second, what is supply dosage of reconstituted Solu-Medrol? When adding 8 mL of diluent, the supply dosage is 62.5 mg per mL © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

Reconstitution Dosage Calculation (Continued) Third, what is resulting total volume of this reconstituted solution? Total volume is 8 mL You know this because 62.5 mg per mL × 8 mL = 500 mg © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

Reconstitution Dosage Calculation (Continued) Finally, how many full doses of Solu-Medrol are available in this vial? Vial contains 500 mg and order is for 200 mg There are two full doses in the vial Reconstitution label is needed © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

Reconstitution Dosage Calculation (Continued) Now you have a vial of 500 mg of Solu-Medrol Add 8 mL of diluent Final yield of the solution is 62.5 mg per mL, your supply dosage Calculate one dose © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

Reconstitution Dosage Calculation (Continued) Step 1: Convert No conversion is necessary Order: Solu-Medrol 200 mg IV every 6 hours Supply: 62.5 mg per mL © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

Reconstitution Dosage Calculation (Continued) Step 2: Think You want to give more than 1 mL You want to give more than three times 1 mL © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

Reconstitution Dosage Calculation (Continued) Step 3: Calculate Given intravenously every 6 hours © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

Solution Strength A fraction expresses strength of a solution made from a liquid concentrate Numerator is number of parts of solute Denominator is number of parts of solution Difference between denominator (final solution) and numerator (parts of solute) is number of parts of solvent © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

Solution Strength (Continued) Example: ⅓ strength nutritional formula 1 part concentrate 3 parts of total solution 3 - 1 = 2 parts solvent (water) © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

D (Desired solution strength) × Q (Quantity of desired solution) Solution Calculation To prepare solutions Apply formula to find amount Quantity of desired solution Amount of liquid solute = Amount of solvent D (Desired solution strength) × Q (Quantity of desired solution) = X (Amount of solute) © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

Solution Calculation (Continued) Example A physician orders a patient’s wound irrigated with strength ⅔ hydrogen peroxide and normal saline solution every 4 hours while awake © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

Solution Calculation (Continued) 60 mL per irrigation for 3 irrigations during your 12 hour shift Prepare 60 mL × 3 irrigations = 180 mL total solution How much stock hydrogen peroxide and normal saline will you need? © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

Solution Calculation (Continued) Step 1: Convert No conversion is necessary © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

Solution Calculation (Continued) Step 2: Think You want to make ⅔ strength 2 parts solute (concentrated hydrogen peroxide) to 3 total parts solution Amount of solvent is 3 – 2 = 1 part saline For 180 mL of solution, you will need ⅔ of it as solute (120 mL) and ⅓ of it as solvent (60 mL) © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

Solution Calculation (Continued) Step 3: Calculate D (Desired solution strength) × Q (Quantity of desired solution) = X (Amount of solute) © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.